American medical care is absurdly expensive, and unavailable to the poor... but it works.
The British National Health Service is moderately priced, and available to everyone... but doesn’t.
Nowhere is the gulf between Brit and Ameri-think more pronounced than in the area of medicine. Attitudes to health and doctors say much about perceptions of self – and the individual’s place in the scheme of things. When it comes to expectation of care, priorities and results – in fact, when it comes to matters of life and death – Brits and Yanks are poles apart.
Britain’s National Health Service is predicated on the idea that medical resources are strictly limited. In the name of fairness, they must be allocated – and priorities determined – by the State. To each according to his need, and so on. Brits believe that first-class public health-care is the foundation of a civilized society... but the ‘first class’ bit presents problems. Quality costs money, and too often already limited supply is forced to meet growing demand... with the result that patients virtually draw straws for time on kidney machines.
Hence, the NHS has come to co-exist in parallel with a private health service, based in London’s Harley Street. Here, senior consultants called ‘Mr’ instead of ‘Dr’ vie with each other to see who can combine the dingiest waiting-room with the steepest prices. This is where the wellheeledcome to enjoy the comforts of second-hand furniture and circumvent a hopelessly clogged public system.
Brits are tormented by the very existence of this private sector, fearing that a ‘two-tier’ systemcreates double standards, in which the poor are bound to lose out. Thus, there is constant pressure for the abolition of said private sector, and the creation of a single tier, in which everyone loses out.
Policy within the overstretched NHS itself is, of necessity, to put the ‘needs of the community’ first (‘we-think’), and individual requirements second. Emergencies are treated as such, but it’s up to doctors – never patients – to decide what’s an emergency and what isn’t. There’s no appeal, unless you wish to change doctors. In any case, Brit consumers of public health-care feel honour-bound to wait their turn. Thousands of thirsty elephants move to the rear, while those in greatest need take a turn at the water-hole first. Hard to say, in the end, who needs a drink most. Thus it occasionally happens that the NHS kills off individuals while raising overall public health standards.
In both sectors Brits have strange notions of the professional relationship between doctor and patient. It can be most nearly described as... hero-worship. Doc is doing The Great I Am. It’s Great Healer vs. Unquestioning Recipient. There’s a view amongst doctors – and subscribed to by patients – that a body is not for the lay person. Your own is none of your business, and should be dealt with only by outside professionals.
If you’ve a pain (and no doubt you’ll be hopeless at explaining it properly) The Doctor will tell you what it is. (He’ll use the patronizing pseudo prol-talk they taught him at medical school... i.e., ‘you’ve got gastro-enteritis. That’s basically a pain in the gut’). Then he’ll prescribe something for it, the contents of which should not concern you. Don’t ask. He takes the view that a little bit of knowledge is a dangerous thing. Brit-patient is meant to be just that.
It must be said, however, that to some extent, Brit-consumers of medical care get what they deserve. Many apparently well-educated people are clueless aboutphysiology. They’ve acquired no understanding of the body, or how it works. They don’t know a gall bladder from an epiglottis, and really do believe that the head-bone’s connected to the stomach-bone.
